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Advanced MRI shape analysis as a predictor of histologically aggressive supratentorial meningioma
Guillaume Friconnet1, Maxime Baudouin1, Waleed Brinjikji2
1Department of Radiology, Centre Hospitalier et Universitaire Dupuytren, Limoges, France.
Background And Purpose:
A subset of aggressive meningioma is associated with higher morbidity and requires a different therapeutic management. This subset consists of World Health Organization (WHO) grade II and III meningioma, characterized particularly with microscopic brain invasion. Numerous studies tried to screen aggressive meningioma on pre-operative MRI. The objective of the study was to determine if an advanced shape analysis of supratentorial meningioma outlines could reliably predict WHO II-III grade and histological brain invasion.
Materials And Methods:
We performed a retrospective analysis for all consecutive patients who underwent surgery for supratentorial histologically-proven meningioma from 2010 to 2018. Pre-operative MRI T1WI contrast enhanced axial, coronal and sagittal slices were collected from 101 patients. Advanced shape analysis including fractal analysis and topological skeleton analysis was performed. Shape analysis parameters were correlated with histopathological WHO grading and brain invasion on surgical pieces.
Results:
Shape analysis features such as a low circularity, a low solidity, a high fractal dimension and a high number of skeleton's branches were significantly correlated with both WHO II-III meningioma and histological brain invasion. Cross-validated regression models including these features were predictive of WHO II-III meningioma and brain invasion with respective AUC of 0.71 and 0.72.
Conclusions:
MRI shape analysis provides informative imaging biomarkers to predict high WHO grade and histological brain invasion of supratentorial meningioma. Further prospective studies including the evaluation of a fully-automatized and totally reproducible process are required to confirm the results.
Insights
Advanced MRI shape analysis can predict aggressive meningioma (World Health Organization [WHO] grade II-III) and brain invasion. This imaging technique offers valuable biomarkers for identifying high-risk tumors, aiding therapeutic management.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Aggressive meningioma (WHO grade II-III) presents significant morbidity and requires distinct therapeutic strategies.
- Microscopic brain invasion is a key characteristic of these aggressive tumors.
- Accurate pre-operative identification of aggressive meningioma is crucial for patient management.
Purpose of the Study:
- To assess the efficacy of advanced shape analysis of supratentorial meningioma outlines on pre-operative MRI.
- To determine if shape analysis can reliably predict World Health Organization (WHO) grade II-III and histological brain invasion.
Main Methods:
- Retrospective analysis of 101 patients with supratentorial meningioma.
- Pre-operative MRI T1WI contrast-enhanced images were analyzed using fractal and topological skeleton analysis.
- Shape parameters were correlated with histopathological WHO grading and brain invasion.
Main Results:
- Lower circularity, lower solidity, higher fractal dimension, and more skeleton branches correlated significantly with WHO grade II-III and brain invasion.
- Regression models incorporating these shape features achieved AUCs of 0.71 for predicting WHO grade II-III and 0.72 for brain invasion.
Conclusions:
- MRI-based shape analysis provides effective imaging biomarkers for predicting high-grade meningioma and brain invasion.
- Further prospective studies are needed to validate these findings with automated and reproducible methods.
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